I had my first pelvic exam at age 13 in a juvenile detention center. It was a frightening, humiliating experience. There was no mother, auntie or other supportive female present to guide me and explain the procedure. Afterwards, as my fellow inmates and I stood naked in a line to receive uniforms, the nurse told us that the doctor had been especially disgusted by our lack of hygiene. I was a runaway and had been sleeping rough for several nights. Sexually abused as a youngster, I was acting out. Although it happened more than 40 yeas ago, the memory can still turn my skin into an uncomfortable prickly garment of shame and anger.

In my line of work, which frequently involves reporting on the challenges faced by Indian girls and women, I am often reminded of the girls I met in the detention center. Girls like 15-year-old Cassandra, who was there because she ran away from her adult husband who had custody of her. In an effort at rehabilitation, the authorities provided us with embroidery supplies to use as we sat mostly watching TV in the cement-block common room. I remember seeing deep red scratches on the backs of girls’ necks and inside their arms—they had gouged themselves with the large embroidery needles. Self -mutilation is not new; it’s an old attempt to gain some sort of authority over a predatory world. Long practiced by incarcerated girls, cutting had been largely ignored until middle class white girls recently discovered it.

Therefore, I don’t much care to hail a new report that presents its findings as something new and heretofore unknown. Sexual Abuse to Prison Pipeline: The Girls’ Story, by the Human Rights Project for Girls, Georgetown Law Center on Poverty and Inequality and the Ms. Foundation for Women was released in early July and is now circulating online. Most Native women and I have known about these things for a long, long time and mostly we work on trying to forget or reinvent ourselves in a healthy way. We know what the current problems are; rather than re-discovering them, we’d rather devote our energy to resolving them.

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First, some facts: Native American girls are at the highest risk of imprisonment in the U.S. According to the report 179 of every 100,000 Native girls end up in prison. The report also states that girls in the juvenile justice system are disproportionately victims of sexual violence. The 2007 Amnesty International report Maze of Injustice found that Native American women and girls are also 2.5 times more likely to be raped or sexually assaulted than any other women in the U.S.

For those working with Native women and girls, the data from the Sexual Abuse to Prison Pipeline comes as no surprise.

“Native girls have the highest rates of poverty and exposure to childhood sexual violence in the nation,” notes Sandi Pierce, president of Otayonih Research in Minnesota. Pierce is a long time researcher on sex trafficking especially among Native women and girls.

Perversely girls, especially girls of color, who experience sexual abuse and violence are routed into the juvenile justice system because of their response to these traumatic experiences, according to the report. Girls’ common reactions to such trauma often include running away from home, substance abuse and truancy. These status violations top the list of crimes for which girls are most likely incarcerated.

“The Report’s findings regarding Native girls are very illuminating, but are also somewhat intuitive, given what we already know about trauma,” Sarah Deer remarked. Deer, of the Muscogee (Creek) Nation, is a long time legal scholar and advocate and is best known for her work focusing attention on the pervasive inequalities of the law regarding sexual and domestic violence for Native American women living on reservations. She is professor of law at William Mitchell College of Law in St. Paul.

Deer added, “Prosecuting sexual assault in Indian country has been a low priority for federal prosecutors until very recently. In many tribal communities, reporting sexual abuse or rape did not result in anything resembling justice. Victims are left to fend for themselves. In trying to cope with trauma, victims may do things that seem counterproductive. Drugs and alcohol may be a young girls effort to self medicate and dull the memories of abuse. Some illegal drugs, for example, can provide temporary relief to someone suffering with flashbacks, panic attacks, and suicidal thoughts. Once a girl is addicted, then she may engage in criminal behavior to satisfy that addiction.”

“When sexual abuse occurs within the extended family, there is really no safe place to go so many Native girls run away. It isn’t fair to label them juvenile delinquents when they are simply seeking to escape unspeakable terror,” she said.

The cost of choosing to punish rather than support girls who have been abused is two-fold according to the report. Abusers are shielded from accountability and girls are sent deeper into the justice system setting into motion a terrible cycle of abuse and imprisonment.

Although some leaders in juvenile justice defend incarcerating victimized girls in order to protect and provide them with services, authors of the report disagree. They note that most juvenile facilities are unaccredited to provide even the most basic medical or mental health care.

The report further noted that conditions in juvenile detention facilities such as strip searches, use of restraint, isolation and the general punitive environment triggers even greater trauma stress symptoms for girls.

“It is no surprise to read that the representation of Native girls in prison settings is more than triple their representation in the population. The systems’ failure to effectively screen and respond to sexual trauma rather than sending Native girls to prison only perpetuates the damage to our communities,” Pierce noted.

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Susan Koepplinger, former executive director of the Minnesota Indian Women’s Resource Center (MIWRC) pointed to the correlation between sexual abuse and sex trafficking especially for Native women and girls. Koepplinger recently joined the George Family Foundation in Minneapolis, a philanthropic organization focused on health, leadership, spirituality and community. Previously, she worked as executive director of MIWRC for more than 10 years. She helped coordinate the Shattered Hearts Report about sex trafficking of Native women.

According to Koepplinger, 75 percent of sex trafficking cases in Minneapolis in 2013 involved Native American victims. She described one of the Center’s programs that serve women incarcerated at the Hennepin County Workhouse and talked about what she saw during her time there. “Over 70 percent of the female prisoners were Native American,” she noted. “Most were incarcerated for prostitution or related charges. We now know that most prostituted women were sexually abused as children.”

She was also unsurprised by the Sexual Abuse to Prison Pipeline report findings. “This data and that from the ACES Study index gives us new validation for what we’ve known for a very long time. (The ACES Study by the Centers for Disease Control and Kaiser Permanente found a connection between adverse childhood experiences and poor health.) When kids grow up in environments filled with toxic stress they have poor outcomes. Trauma impacts children’s health, academic performance, economic status and therefore negatively impacts the entire community,” Koepplinger noted.

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Fortunately, this data about the correlation between childhood trauma and poor health and social outcomes provides us with new opportunities to address these problems according to Koepplinger and authors of the Pipeline to Prison Report. This, then, is the information I would like to see circulating, rather than another recitation of the dire circumstances our young girls find themselves in.

Report authors recommendations include:

— Enacting effective and universal Safe Harbor laws in all states. Safe Harbor laws offer immunity to trafficked youth and ensure they are treated as victims rather than perpetrators.

— Require facilities to be accredited for provision of medical care.

— Strengthen the Juvenile Justice and Delinquency Prevention Act (JJDPA) that set standards for states’ operation of juvenile justice systems. Enacted in 1974, the act has not been reauthorized since 2002. Reauthorization is critical to funding services.

— Use Medicaid funds to improve quality care and trauma related services for girls in child welfare. Many girls in foster care report histories of sexual abuse and subsequently end up in jail.

“We can look at upstream factors in a preventative way rather than sticking chewing gum into a dike that’s leaking,” according to Koepplinger. “Our societal response of getting tougher on crime and incarcerating children rather than addressing their needs has not worked.”

Producing good outcomes for children includes strengthening families and helping them to grow up in safe environments. “We are beginning to understand how we can heal trauma; we now have enough knowledge to interrupt the impact of trauma on human beings. We can help people learn meaningful self care using mind/body cultural healing,” Koepplinger said. “These maladaptive behaviors that land kids in jail are really just trauma acting out.”